Objective:To analyze the effects of sufentanil combined with dezocine on serum cortisol(Cor), norepinephrine (NE), epinephrine (E) and adrenocorticotropic hormone (ACTH) levels in patients undergoing thyroid surgery.Methods:A total of 116 patients who underwent elective thyroid surgery in the Enshi Tujia and Miao Autonomous Prefecture Central Hospital from July 2019 to November 2021 were retrospectively selected. All patients were given mechanical analgesia pump for postoperative analgesia, and were divided into the control group (58 cases) and the observation group (58 cases) according to different drug formulations. The control group was given sufentanil + tropisetron hydrochloride for postoperative analgesia. Postoperative analgesia in the observation group was administrated with dezocine + sufentanil + tropisetron hydrochloride. The postoperative pain and sedation of the two groups were observed, and the levels of serum Cor, NE, E and ACTH and the occurrence of adverse reactions were compared between the two groups.Results:The visual analogue scale (VAS) scores in the observation group at 2, 6, 12 and 24 h after operation were lower than those in the control group, and the Ramsay scale scores were higher than those in the control group, there were statistical differences ( P<0.05). After operation, the levels of Cor, NE, E and ACTH in the observation group were lower than those in the control group: (857.81 ± 186.30) nmol/L vs. (1 082.20 ± 169.64) nmol/L, (1 469.40 ± 201.47) pmol/L vs. (1 548.42 ± 202.59) pmol/L, (498.17 ± 69.56) pmol/L vs. (630.47 ± 73.55)pmol/L, (15.35 ± 3.88) pmol/L vs. (17.36 ± 4.03) pmol/L, there were statistical differences ( P<0.05). The incidence of adverse reactions in the observation group was lower than that in the control group:12.07% (7/58) vs. 32.76% (19/58), there was statistical difference ( χ2 = 7.14, P<0.01). Conclusions:Sufentanil combined with dezocine for postoperative analgesia in patients undergoing thyroid surgery can exert sedative and analgesic effects by adjusting serum Cor, NE, E and ACTH levels, and reduce stress response, with good safety.

Cervical cancer is one of the most common gynecological malignant tumors in China. Given their lack of obviously early symptoms, more than half of patients with cervical cancer are diagnosed in the middle and late stages of this malignancy, resulting in poor prognosis. Finding new therapeutic targets is the current research direction. Metabolomics, as a new omics technology, is expected to provide new targets for tumor precision diagnosis and treatment through the analysis of the changes and potential mechanisms of metabolites in tumor occurrence and development by chromatography, mass spectrometry, and other technologies. Herein, we review the research methods of metabolomics; metabolic characteristics of cervical cancer; and progress of the research on metabolomics in cervical cancer diagnosis, curative effect prediction, and prognosis evaluation to provide new ideas for the precise diagnosis and treatment of cervical cancer.

Objective:To analyze the effects of sufentanil combined with dezocine on serum cortisol(Cor), norepinephrine (NE), epinephrine (E) and adrenocorticotropic hormone (ACTH) levels in patients undergoing thyroid surgery.Methods:A total of 116 patients who underwent elective thyroid surgery in the Enshi Tujia and Miao Autonomous Prefecture Central Hospital from July 2019 to November 2021 were retrospectively selected. All patients were given mechanical analgesia pump for postoperative analgesia, and were divided into the control group (58 cases) and the observation group (58 cases) according to different drug formulations. The control group was given sufentanil + tropisetron hydrochloride for postoperative analgesia. Postoperative analgesia in the observation group was administrated with dezocine + sufentanil + tropisetron hydrochloride. The postoperative pain and sedation of the two groups were observed, and the levels of serum Cor, NE, E and ACTH and the occurrence of adverse reactions were compared between the two groups.Results:The visual analogue scale (VAS) scores in the observation group at 2, 6, 12 and 24 h after operation were lower than those in the control group, and the Ramsay scale scores were higher than those in the control group, there were statistical differences ( P<0.05). After operation, the levels of Cor, NE, E and ACTH in the observation group were lower than those in the control group: (857.81 ± 186.30) nmol/L vs. (1 082.20 ± 169.64) nmol/L, (1 469.40 ± 201.47) pmol/L vs. (1 548.42 ± 202.59) pmol/L, (498.17 ± 69.56) pmol/L vs. (630.47 ± 73.55)pmol/L, (15.35 ± 3.88) pmol/L vs. (17.36 ± 4.03) pmol/L, there were statistical differences ( P<0.05). The incidence of adverse reactions in the observation group was lower than that in the control group:12.07% (7/58) vs. 32.76% (19/58), there was statistical difference ( χ2 = 7.14, P<0.01). Conclusions:Sufentanil combined with dezocine for postoperative analgesia in patients undergoing thyroid surgery can exert sedative and analgesic effects by adjusting serum Cor, NE, E and ACTH levels, and reduce stress response, with good safety.

Objective:To standardize the origin of Rubi Fructus by using ITS2 and matK molecular markers to identify Rubi Fructus and its analogues. Methods:The ITS and matK sequences of Rubus chingii Hu, Rubus corchorifolius L.f., Rubus hirsutus Thunb., Rubus parvifolius L., Rubus buergeri Miq. and Rubus lambertianus Ser. were amplified and sequenced. The hidden Markov model was used to remove 5.8S and 28S from ITS sequences. A total of 25 ITS2 sequences were obtained. And a total of 22 matK sequences were obtained by proofreading by Glustal software. MEGA software was used for matK and ITS2 sequences analysis, intraspecific and interspecific genetic distances caculation, and neighbor joining (NJ) phylogenetic tree construction. ITS2 secondary structure was predicted by ITS2 database and aligned by 4Sale software. Profile neighbor-joining (PNJ) phylogenetic tree was constructed based on combined ITS2 sequence and its secondary structure by ProfDistS software. Results:An obvious barcoding gap between Rubi Fructus and its analogues was showed. The topological relationship between NJ tree and PNJ tree was consistent, and each taxon exhibits monophyly. The ITS2 secondary structure of Rubi Fructus was significant different from its analogues.Conclusions:It is recommended that both ITS2 and matK markers can serve as DNA barcodes for identifying Rubi Fructus and its analogues. The addition of ITS2 secondary structure information can enrich the identification results and provide theoretical support for resource research and variety selection of Rubi Fructus.

Spinocerebellar ataxia (SCA) is a group of progressively aggravated neurodegenerative disease with autosomal dominant inheritance. Cerebellar ataxia is the core symptom, which may be accompanied by pyramidal tract signs, extrapyramidal signs, cognitive dysfunction and peripheral neuropathy. Although SCA can be accurately diagnosed by genetic testing, treatment is still difficult. We review the pathogenesis and therapeutic targets of SCA in recent years, in terms of genetic or gene regulation abnormalities, disruption of protein quality control (PQC) network, disruption of energy homeostasis, stability maintenance of PQC system, maintenance of cerebellar Purkinje cell function, and regulation of neuroinflammation, so as to promote the transformation of preclinical research into human therapy.

Objective:To investigate the effect of exercise rehabilitation on frailty of elderly patients with coronary heart disease after percutaneous coronary intervention (PCI) .Methods:From January to December 2021, 80 elderly patients with coronary heart disease who received PCI in Qinhuai Medical Area of General Hospital of Eastern Theater Command were selected as the study subject by convenience sampling. A total of 39 patients from January to June 2021 were set in the control group, and 41 patients from July to December 2021 were set in the experimental group. The control group was given routine nursing, and the experimental group was given systematic exercise rehabilitation on the basis of the control group. The effects of intervention were evaluated by Tilburg Frailty Index (FI) , Cardiac Exercise Self-Efficacy Instrument (CESEI) , cardiac function, exercise tolerance, and 6-minute Walking Distance (6MWD) .Results:There was no significant difference in FI and CESEI scores between the two groups before intervention ( P>0.05) . After intervention, the FI score of patients in the experimental group was lower than that in the control group, and the CESEI score was higher than that in the control group, with statistically significant differences ( P<0.05) . There was no significant difference in cardiac function, exercise tolerance and 6MWD between the two groups before intervention ( P>0.05) . After intervention, there were statistically significant differences in cardiac function, exercise tolerance and 6MWD between the two groups ( P<0.05) . Conclusions:Exercise rehabilitation can effectively alleviate the frailty of elderly patients with coronary heart disease after PCI, improve their exercise compliance, cardiac function and exercise tolerance, which is worthy of clinical promotion.

Objective:To analyze the research hotspots of the application of mobile health in cardiac function monitoring of patients with heart disease and to conduct a visual analysis.Method:Subject field retrieval was carried out based on Web of Science Core Collection. The retrieval time range was set from 2000 to 2022, and the type of paper was limited to treatise. The retrieved literatures were imported into Endnote 7 for screening, and the repetitive and unrelated literatures were excluded. A total of 291 literatures were included in this study. Open refine 2.8 was used for data cleaning of synonyms and then VOSviewer 1.6.18 was used for visualization analysis of country/region, author and keywords.Results:Research reports on the application of mobile medical in the field of cardiac function monitoring in patients with heart disease have been growing steadily since 2005, and the number of articles published in the field increased rapidly from 2020 to 2021. The top five countries with the highest number of publications were the United States (71) , Australia (20) , China (18) , the United Kingdom (14) and Sweden (13) . The cooperation and exchange among global researchers were relatively close, but they were still dominated by regional cooperation and had not formed a large core group of authors. A total of 71 high-frequency keywords were included, and the top five were mhealth (30 times) , heart failure (27 times) , smartphone (26 times) , telemedicine (15 times) and mobile phone (17 times) . Each cluster keyword was related to each other, which represented the current research hotspot content respectively.Conclusions:At present, number of publications in China ranks first in the world, but there is still a big gap compared with the United States. The development and optimization of monitoring equipment and mobile medical APP have become the focus and hot topics.

Lung cancer is the malignant tumor with the highest morbidity and mortality in China. Non-small cell lung cancer (NSCLC) is the main pathological subtype of lung cancer. On April 13, 2023, the National Comprehensive Cancer Network (NCCN) released the third edition of the 2023 NCCN Oncology Clinical Practice Guidelines: Non-small Cell Lung Cancer, which reflects the latest advances in international lung cancer research. This article will interpret the main updated contents of the new edition of the guidelines, and compare it with the third edition of the NCCN guidelines in 2022, so as to provide references about the diagnosis and treatment of NSCLC for clinical medical personnel in China.
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Humans ; Carcinoma, Non-Small-Cell Lung ; China ; Lung Neoplasms ; Thorax

【Objective】 To analyze the impact of sporadic cases of COVID-19 on the work of Transfusion Department, so as to explore the countermeasures. 【Methods】 The admission of inpatient departments, the reception of outpatient(including emergency) departments, the workload of transfusion department(including blood typing, unexpected antibody screening and cross matching), and the consumption of blood components in the Xijing Hospital between October and November in 2021, during COVID-19 outbreak, were collected. All the above data was statistically compared to the data in same period in 2018, before the COVID-19 outbreak. 【Results】 Due to the COVID-19 epidemic, there was a significant decrease in number of inpatients(280±157.1 vs 340.4±110.2), outpatient(including emergency)(8 359±3 615 vs 10 151±3 225), the workload of blood typing(272.0±132.4 vs 341.6±110.4), unexpected antibody screening(78.26±42.22 vs 98.51±43.53) and crossmatch(237.2±99 vs 475.7±155.6), as well as the consumption(U) of all blood components(457.9±50.32 vs 579.4±62.51) in the Xijing Hospital(P<0.05). In detail, the epidemic had the most direct impact on the number of inpatients and outpatients, which shrank continuously on the 2^nd day after official announcement of the new COVID-1 cases. While the workload of blood typing, unexpected antibody screening and crossmatch decreased slightly, with a lag, usually on the 2^nd, 3^rd and 5^th day after official announcement. The decrease of the usage of red blood cells and plasma began from the 7^th day after the new epidemic to the 6^th day after the end of the epidemic. However, the usage platelets and cryoprecipitate coagulation factors decreased from the 8^th and 10^th day after the new epidemic to the 2^nd and 6^th day after the end of the epidemic, respectively. 【Conclusion】 The daily work of Blood Transfusion Department has been seriously affected by sporadic COVID-19 epidemic. The working mode, staff structure and inventory ratio of blood components should be adjusted and optimized instantly to maintain the normal conduct of medical treatments in hospitals and ensure the safety of patients.

Objective:To investigate the correlation between intrahepatic triglyceride content (IHTC) and glucose metabolism in patients with non-alcoholic fatty liver disease (NAFLD) diagnosed by proton magnetic resonance spectroscopy ( 1H-MRS). Methods:A total of 239 subjects without diabetes mellitus were previously enrolled and underwent 1H-MRS scans. Anthropometric indexes including height, weight, waist and blood pressure, and laboratory findings as plasma glucose (PG), insulin (INS), C-peptide (CP), liver enzymes [alanine aminotransferase (ALT), aspartate transaminase (AST), γ-glutamyl transpeptidase (GGT)] and lipid profiles were collected. According to IHTC levels, participants were divided into three groups: the non-NAFLD group (IHTC<5.56%), the mild NAFLD group (IHTC 5.56%-<33%), and the moderate and severe NAFLD group (IHTC ≥ 33%). The clinical characteristics of each group were analyzed, and the correlation between IHTC and glucose metabolism were assessed. Results:Compared with those in the non-NAFLD group, male proportion, waist, 120 min postprandial PG (PG120), CP, liver enzymes and total cholesterol (TC) levels were greater in the NAFLD group, whereas insulin sensitivity index-Cederholm (ISI-Cederholm) and high density lipoprotein cholesterol (HDL-C) levels were lower in the NAFLD groups. Subjects in the moderate and severe NAFLD group had higher levels of 120 min postprandial INS (INS120) and Stumvoll indexes, and lower ISI-Cederholm than those in the mild NAFLD group [80.37 (57.68, 112.70) mU/L vs.110.50(71.78, 172.80)mU/L, 1453(1178, 1798)vs.1737(1325, 2380), 358(297, 446) vs.441(318, 594), 2.27(2.01, 2.53) vs.2.06(1.81, 2.39), respectively, all P<0.05]. Correlation analyses showed that IHTC was significantly positively correlated with waist hip ratio (WHR), PG120, INS120, HOMA insulin resistance (HOMA-IR), Stumvoll 1st-insulin secretion, Stumvoll 2nd-insulin secretion, ALT, AST, GGT and TC ( r=0.197, 0.274, 0.334, 0.162, 0.199, 0.211, 0.406, 0.361, 0.215, and 0.196, respectively, all P<0.05), and negatively correlated with ISI-Cederholm and HDL-C ( r=-0.334, and-0.237, respectively, all P<0.05). Furthermore, a multiple linear stepwise regression analysis indicated that ISI-Cederholm (Standardized β =-0.298, P<0.001) and Stumvoll 1st insulin secretion (Standardized β = 0.164, P = 0.024) were independent factors of IHTC. Conclusions:Peripheral insulin resistance occurs in the early stage of NAFLD and becomes worse with the progression of the disease. IHTC was independently associated with insulin sensitivity and first-phase insulin secretion.